Department of Radiology, University Hospital of North-Norway, Tromsø, Norway; Department of Clinical Medicine, UiT, The Arctic University of Norway, Tromsø, Norway.
Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Eur J Radiol. 2022 Aug;153:110365. doi: 10.1016/j.ejrad.2022.110365. Epub 2022 May 20.
To describe the appearances of bone marrow in the appendicular skeleton on fat-suppressed T2-weighted sequences as assessed by whole-body MRI in healthy and asymptomatic children and adolescents.
Following ethical approval, we assessed the bone marrow of the extremities on water-only Dixon T2-weighted images as part of a whole-body MRI in 196 healthy and asymptomatic children aged 5-19 years. Based on a newly devised and validated scoring system, we graded intensity (0-2 scale) and extension (1-4 scale) of focal high signal bone marrow areas, and divided them into minor or major findings, based on intensity and extension, reflecting their potential conspicuousness in a clinical setting.
In the upper extremity, we registered 366 areas with increased signal whereof 79 were major findings. In the lower extremities there were 675 areas of increased signal of which 340 were major findings. Hundred-and-fifteen (58.79%) individuals had at least one major finding, mainly located in the hand and proximal humerus, and the feet and knees. We found no differences according to gender, reported hours of sports activity, handedness, or age group, except for more minor findings in the upper extremities amongst 15-18-year-olds as compared to those aged 5-8 years.
Focal areas of high signal intensity on whole-body MRI, T2-weighted fat suppressed images that, in a clinical setting could cause concern, were seen in more than half of healthy, asymptomatic children and adolescents. Awareness of this is important when interpreting whole-body MRI in this age group, particularly in the assessment of clinically silent lesions.
描述健康无症状儿童和青少年全身 MRI 检查中四肢骨髓在脂肪抑制 T2 加权序列上的表现。
本研究获得伦理批准后，对 196 名 5-19 岁健康无症状儿童的四肢骨髓进行了水激发 Dixon T2 加权成像评估，作为全身 MRI 的一部分。我们采用了新制定的且经过验证的评分系统，对局限性高信号骨髓区域的强度（0-2 级）和延伸程度（1-4 级）进行分级，并根据强度和延伸程度将其分为小或大发现，以反映其在临床环境中的潜在明显性。
在上肢，我们记录了 366 个信号增强区域，其中 79 个为大发现；在下肢，有 675 个信号增强区域，其中 340 个为大发现。115 人（58.79%）至少有一个大发现，主要位于手部和近端肱骨以及足部和膝盖。我们没有发现性别、报告的运动时间、惯用手或年龄组之间的差异，但 15-18 岁组上肢的小发现比 5-8 岁组更多。
在全身 MRI 的 T2 加权脂肪抑制图像上，可以看到超过一半的健康无症状儿童和青少年存在局限性高信号强度区域，如果在临床环境中可能会引起关注。在该年龄组解读全身 MRI 时，了解这一点非常重要，特别是在评估临床无症状病变时。
